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Sunday, October 9, 2011

Antihypertensive Shows Promise for Autism

From Medscape Medical News > Psychiatry
Fran Lowry
October 6, 2011 — The beta blocker propranolol, a drug widely used to treat hypertension and anxiety disorders, may also be beneficial for improving language and social function in people with autism, according to new research published in the March issue of Cognitive and Behavior Neurology.
"There is a lot of evidence to suggest a rigidity of the networks of the brain in autism," lead author David Q. Beversdorf, MD, from the University of Missouri, Columbia, told Medscape Medical News. "People take propranolol for anxiety, and we know from our past research that propranolol reverses the effect of stress, and can slow you down, so we thought it might be worth trying in people with autism."
In previous studies, Dr. Beversdorf found that propranolol helped people solve word puzzles and also increased their semantic word fluency, or their ability to understand the definition of words. In the current study, they sought to see whether the drug would have a similar effect in people with autism.
In 2 different testing sessions, 14 high-functioning teenagers and adults with autism and 14 matched control patients were given letter and category word fluency tasks.
The first test was given 60 minutes after the administration of 40 mg oral propranolol, and the second test was given after administration of the placebo, administered in a double-blind, counterbalanced manner.
Compared with the control participants, the patients with autism were significantly impaired on both the fluency tasks.
The study found that propranolol significantly improved performance on category fluency, but not letter fluency, in participants with autism.
After taking 1 dose of propranolol, patients with autism were able to name, on average, 11 types of animal in 30 seconds vs 9 types in the same time before taking the drug.
Dr. Beversdorf added that he currently is seeking a grant to do a larger clinical trial, with more patients, to see whether they can predict who will respond to propranolol with brain imaging.
"Obviously, the downstream hope is that we will bring something that is clinically beneficial for patients. Propranolol doesn't cost a lot because it is generic and it has been used safely for a long time. We know what its side effects are, and we know who and who not to give it to."
Innovative Study
Medscape Medical News invited Marjorie Solomon, PhD, from the MIND Institute at the University of California, Davis, Medical Center in Sacramento, to comment on the study.
"Although it is small and awaits replication, this is a very innovative trial for several reasons," Dr. Solomon, who was not part of the study, said in an interview.
"First, as pointed out by the authors, there has been very little work to assess the efficacy of psychopharmacological interventions for the cognitive impairments found in autism. Cognitive flexibility is one of the most frequently cited everyday problems for persons with autism," she said.
Second, the authors developed their hypothesis within the context of a computational model of autism, Dr. Solomon noted. "Although this approach has been used to study other disorders like schizophrenia, they are the first to use it in autism."
Dr. Beversdorf and Dr. Solomon have disclosed no relevant financial relationships.
Cog Behav Neurol. 2011;24:11-17. Abstract

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